Bacteraemia and quick Sepsis Related Organ Failure Assessment (qSOFA) are independent risk factors for long-term mortality in very elderly patients with suspected infection: retrospective cohort study.
Por:
Hernández-Quiles R, Merino-Lucas E, Boix V, Fernández-Gil A, Rodríguez-Díaz JC, Gimeno A, Valero B, Sánchez-Martínez R and Ramos-Rincón JM
Publicada:
13 mar 2022
Ahead of Print:
13 mar 2022
Resumen:
BACKGROUND: In older adult patients, bloodstream infections cause significant mortality. However, data on long-term prognosis in very elderly patients are scarce. This study aims to assess 1-year mortality from bacteraemia in very elderly patients. METHODS: Retrospective cohort study in inpatients aged 80 years or older and suspected of having sepsis. Patients with (n = 336) and without (n = 336) confirmed bacteraemia were matched for age, sex, and date of culture, and their characteristics were compared. All-cause mortality and risk of death were assessed using the adjusted hazard ratio (aHR). RESULTS: Compared to controls, cases showed a higher 1-year mortality (34.8% vs. 45.2%) and mortality rate (0.46 vs. 0.69 deaths per person-year). Multivariable analysis showed significant risk of 1-year mortality in patients with bacteraemia (aHR: 1.31, 95% confidence interval [CI] 1.03-1.67), quick Sepsis Related Organ Failure Assessment (qSOFA) score of 2 or more (aHR: 2.71, 95% CI 2.05-3.57), and age of 90 years or older (aHR 1.53, 95% CI 1.17-1.99). CONCLUSIONS: In elderly patients suspected of sepsis, bacteraemia is associated with a poor prognosis and higher long-term mortality. Other factors related to excess mortality were age over 90 years and a qSOFA score of 2 or more.
Filiaciones:
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Clinical Medicine Department, Miguel Hernández University, Crta. Nacional, N-332 s/n, 03550 San Joan d'Alacant Campus, Alicante, Spain
Dermatology Service, General University Hospital of Alicante and Institute for Health and Biomedical Research of Alicante (ISABIAL), Av. Pintor Baeza, 12, 03010, Alicante, Spain
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Infectious Diseases Unit, General University Hospital of Alicante and Institute for Health and Biomedical Research of Alicante (ISABIAL), Av. Pintor Baeza, 12, 03010, Alicante, Spain
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Clinical Medicine Department, Miguel Hernández University, Crta. Nacional, N-332 s/n, 03550 San Joan d'Alacant Campus, Alicante, Spain
Infectious Diseases Unit, General University Hospital of Alicante and Institute for Health and Biomedical Research of Alicante (ISABIAL), Av. Pintor Baeza, 12, 03010, Alicante, Spain
Fernández-Gil A:
Clinical Medicine Department, Miguel Hernández University, Crta. Nacional, N-332 s/n, 03550 San Joan d'Alacant Campus, Alicante, Spain
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Microbiology Service, General University Hospital of Alicante and Institute for Health and Biomedical Research of Alicante (ISABIAL), Av. Pintor Baeza, 12, 03010, Alicante, Spain
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Microbiology Service, General University Hospital of Alicante and Institute for Health and Biomedical Research of Alicante (ISABIAL), Av. Pintor Baeza, 12, 03010, Alicante, Spain
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Internal Medicine Department, General University Hospital of Alicante and Institute for Health and Biomedical Research of Alicante (ISABIAL), Av. Pintor Baeza, 12, 03010, Alicante, Spain
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Internal Medicine Department, General University Hospital of Alicante and Institute for Health and Biomedical Research of Alicante (ISABIAL), Av. Pintor Baeza, 12, 03010, Alicante, Spain
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Clinical Medicine Department, Miguel Hernández University, Crta. Nacional, N-332 s/n, 03550 San Joan d'Alacant Campus, Alicante, Spain.
Internal Medicine Department, General University Hospital of Alicante and Institute for Health and Biomedical Research of Alicante (ISABIAL), Av. Pintor Baeza, 12, 03010, Alicante, Spain.
gold, Green Published
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